The objectives of this proposal are to evaluate, by means of a collaborative group, the therapeutic choices made by urologists who care for patients with bladder carcinoma and to subsequently improve the care which those patients receive. All patients admitted to the collaborating institutions will be placed in the following protocols: Protocol 1 - A protocol for surveillance of patients with primary bladder neoplasms; Protocol 2 - A protocol to investigate non-cancerous vesical epithelium (non-cancerous by cystoscopic observation) by means of selected mucosal biopsies in patients with bladder cancer and patients with positive urinary cytology without cystoscopically visible bladder cancer; Protocol 3 - A protocol to determine the effect of the intra-vesical instillation of THIO-TEPA on non-invasive bladder cancer and the recurrence rate of tumor in these patients; and Protocol 4 - A protocol to determine the results of external irradiation and combined irradiation and surgery as definitive therapy for patients with invasive primary bladder carcinoma.